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Review
. 2021 Jun 3;9(1):19.
doi: 10.1186/s40345-021-00224-6.

Patients' adherence to smartphone apps in the management of bipolar disorder: a systematic review

Marie-Camille Patoz  1 , Diego Hidalgo-Mazzei  2 , Bruno Pereira  1 , Olivier Blanc  1 , Ingrid de Chazeron  1 , Andrea Murru  2 , Norma Verdolini  2 , Isabella Pacchiarotti  2 , Eduard Vieta  2 , Pierre-Michel Llorca  1   3 , Ludovic Samalin  4   5   6
Affiliations
Review

Patients' adherence to smartphone apps in the management of bipolar disorder: a systematic review

Marie-Camille Patoz et al. Int J Bipolar Disord. .

Abstract

Background: Despite an increasing number of available mental health apps in the bipolar disorder field, these tools remain scarcely implemented in everyday practice and are quickly discontinued by patients after downloading. The aim of this study is to explore adherence characteristics of bipolar disorder patients to dedicated smartphone interventions in research studies.

Methods: A systematic review following PRISMA guidelines was conducted. Three databases (EMBASE, PsychInfo and MEDLINE) were searched using the following keywords: "bipolar disorder" or "mood disorder" or "bipolar" combined with "digital" or "mobile" or "phone" or "smartphone" or "mHealth" or "ehealth" or "mobile health" or "app" or "mobile-health".

Results: Thirteen articles remained in the review after exclusion criteria were applied. Of the 118 eligible studies, 39 did not provide adherence characteristics. Among the selected papers, study length, sample size and definition of measures of adherence were strongly heterogeneous. Activity rates ranged from 58 to 91.6%.

Conclusion: The adherence of bipolar patients to apps is understudied. Standardised measures of adherence should be defined and systematically evaluated in future studies dedicated to these tools.

Keywords: Bipolar disorder; Mobile application; Smartphone; Systematic review.

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Conflict of interest statement

Dr. Pacchiarotti has received CME-related honoraria, or consulting fees from ADAMED, Janssen-Cilag and Lundbeck. Dr. Murru has served as a consultant, adviser or speaker for Adamed, AstraZeneca, Bristol-Myers Squibb, Janssen-Cilag, Lundbeck, Otsuka and Sanofi-Aventis and has received a grant (PI19/00672) from the Instituto de Salud Carlos IIISubdirección General de Evaluación y Fomento de la investigación, Plan Nacional 2019–2022. Prof. Vieta has received grants and served as a consultant, advisor or CME speaker for the following entities: AB-Biotics, Abbott, Allergan, Angelini, AstraZeneca, Bristol-Myers Squibb, Dainippon Sumitomo Pharma, Farmindustria, Ferrer, Forest Research Institute, Gedeon Richter, Glaxo-Smith-Kline, Janssen, Lundbeck, Otsuka, Pfizer, Roche, SAGE, Sanofi-Aventis, Servier, Shire, Sunovion, Takeda, the Brain and Behaviour Foundation, the Spanish Ministry of Science and Innovation (CIBERSAM), the EU Horizon 2020 and the Stanley Medical Research Institute. Prof. Llorca has received grants, honoraria or consulting fees from ESAI, Gedeon Richeter, Janssen, Lundbeck, Otsuka and Sanofi. Dr. Samalin has received grants, honoraria or consulting fees from AstraZeneca, Bristol-Myers Squibb, Janssen-Cilag, Lundbeck, Otsuka, Sanofi-Aventis, and Takeda. The other authors declare that they have no conflicts of interest.

Figures

Fig. 1
Fig. 1
Prisma flowchart
Fig. 2
Fig. 2
Mean and standard-deviation of age of participants in the included studies taking into account the between- and within-study variability
See this image and copyright information in PMC

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